Full Dose Cyclosporine Versus Low Dose Takrolimus as Maintenance Immunosuppression in Renal Transplant Recipients with Posttransplant Diabetes Mellitus

OBJECTIVE: The aim of our study was to determine the effect and safety of low dose tacrolimus instead of switching to cyclosporine in patients with new onset diabetes after renal transplantation (NODAT) associated with takrolimus use.

MATERIAL and METHODS: Sixty six patients who underwent renal transplantation at our center between 2003 and 2008 and diagnosed NODAT in accordance to ADA criteria were included in the study. Patients were allocated into two groups; group 1: low dose tacrolimus users (n:36 patients), group 2: those who were switched to standard doses of cyclosporine (n: 30 patients). Glycemia controls during the preceding and following year of DM diagnosis, total acute rejection ratios, graft functions and graft survival ratios were compared.

RESULTS: Blood glucose levels were similar in the first 6 months, but were lower in the cyclosporine group at the end of the first year (p:0,022),. On the other hand, HbA1C levels were found to be lower at 6th month in tacrolimus group(p: 0,03). Acute rejection and graft survival ratios were similar. The glomerular filtration rate was higher at the 6th month in low dose tacrolimus group.

CONCLUSION: Low dose tacrolimus or switching to a standard cyclosporine protocol have similar effects in patients with NODAT associated with tacrolimus use.